Double Amputee Has Advice For Boston Victims

This is TELL ME MORE from NPR News. I'm Michel Martin. Later in the program we are going to talk about a new study that says that some seniors are actually carrying more debt than their younger peers. We'll dig into that in just a few minutes. But first we want to turn back to Boston. And with one suspect in custody and the other deceased, we're turning our attention to the people whose lives were most changed by the bomb attack at the marathon last week.

We're thinking in particular of the people who lost limbs. We understand that at least 14 people to this point have had to have limbs amputated. We wanted to know what was in store for them as they heal, as well as what role the rest of us can play in supporting them and others who are going through this. So we've called upon Ignacio Gaunaurd. He is a physical therapist who works for the Miami Veterans Affairs Healthcare system.

He has a doctorate in physical therapy with a specialization in amputee rehabilitation. Also joining us is Kari Miller. She is a Paralympic volleyball player and two-time silver medalist and a military veteran and a double amputee. Welcome to you both. Thank you both so much for joining us.

KARI MILLER: Thanks for having us.

IGNACIO GAUNAURD: Thank you.

MARTIN: Kari, let me just start by saying congratulations on your second silver medal, by the way.

MILLER: Thank you.

MARTIN: If I can slip that in. I mentioned that you're a military veteran but you didn't lose your legs in combat, as I understand.

MILLER: No. Actually, I was home celebrating. I was going to be promoted to captain - I mean, I'm sorry, an officer. And a drunk driver ran into me. So that's how I ended up losing my legs.

MARTIN: Did you know at the time you were going to lose your legs? I mean was it a situation where you thought I know this is what's going to happen and you were able to kind of mentally prepare?

MILLER: I don't know about mentally preparing. I mean I was in the car and I was trapped and I was kind of - when the guy cut - I looked up and the guy had cut the top off the car. And I was like whatever you need to do to get me off, if you need to cut my legs off, I'll forgive you, you know. And he just gave me a hug and knocked me out and I woke up and I just knew that they were gone.

MARTIN: Do your remember those first moments when you knew that your legs were gone and you were going to have to adjust to that? Do you remember those moments?

MILLER: I do. I mean I sat back and I thought about it and for some reason, like, I guess there was like a winter Olympics or something ahead of time and I remember seeing a guy skiing with one leg. And me and my mom were sitting on the couch and we were laughing and we were like, man, this guy is an overachiever. If I lost my legs I wouldn't do - I'd be laying on the couch.

So that was one of the things that kind of - I was like, well, I guess I'll be walking and not be able to move, because I had seen it before. You know?

MARTIN: Hmm. OK. Well, it seems like you have a great attitude. Mr. Gaunaurd, I'm thinking that a great attitude probably goes a long way at a time like this. But can you talk about what you've seen? If you feel comfortable saying this, well, how do most people react, at least in those early stages of losing a limb or limbs?

GAUNAURD: It all depends on, I guess, their frame of mind, but I think there's also, like, those stages of loss. An individual may be depressed, they may be angry. They may be a stage of disbelief or bargaining. And then at some point, whether it occurs very quickly or later on in the rehab process, they'll accept, you know, their current situation, they'll move forward.

And it's excellent that there are support groups out there that help these individuals adjust to these, to such a horrific, you know, incident such as Amputee Coalition.

MARTIN: Have you noticed a difference in how people react depending on how they came to lose their legs? Because there's all kinds of reasons why. I mean you've got somebody like Kari Miller here who was serving in the military. Presumably at some point you've enlisted. You got the notion that you could be injured at some point, as opposed to an accident. I mean I don't think she ever envisioned that happening.

Does that matter, like the circumstances, in terms of how people will respond to it?

GAUNAURD: I think it's pertaining to someone who's - like these individuals who lost their limbs in the Boston Marathon. Those incidents are a little more visual to our society. I think those who lose limbs to diabetes or peripheral vascular disease, you'll see a lot of those more in the hospital situations and it's not in the media as much.

And I think these incidents are what I guess - or I can, like I say, all our service members coming back from Iraq and Afghanistan, they've been able to - and the successes that they've had after limb loss have really brought to light that these individuals with limb loss can move forward following their incidents. They can achieve well beyond any expectations that we have as a physical therapist or as clinicians.

That kind of mindset stays the same. I just think that visually, those with diabetes or peripheral vascular disease, you really don't - you don't see them as often but I think their expectations are still the same.

MARTIN: Presumably the people at that marathon, I mean some of the people who were injured were spectators but there were also many people who were athletes.

MILLER: Right.

MARTIN: Like Kari was both an athlete...

GAUNAURD: Yes.

MARTIN: ...very physically fit. But I'm just saying, I'm thinking about the anger. I mean the idea that somebody did this to you.

MILLER: You know...

MARTIN: I mean, Kari, do you want to take that on? I mean...

MILLER: Yeah. And for me, I think that it depends on - no injury, I don't care what it is, from spinal cord to whatever - no person from person to person in their injury process is going to go through it the same exact way. So if I get injured or if I, you know, some of the soldiers that I visit or train get injured, sometimes, you know, the guys will go through it and he'll be, you know, just depressed and angry for years, while a guy who's lost even more is ready, up and ready to go in a week. It kind of depends on where they're coming from in life, the support system - and the support system that they have behind them. You know? So I mean, that's the way I kind of feel about it.

MARTIN: Were you angry?

MILLER: I wasn't angry. It was kind of like why me at first. Like, jeez, man, really? But I guess one of the other parts of it is that my mom was such a big part of my life. You know, she was a really strong woman and I kind of saw when I first woke up her being so nervous and afraid.

You know, I've always had a way of, OK, I want to do this next in my life. You know, I kind of had it, like, planned out. And so once I was able to get my mom, like, you know, to - when I woke up and I was, you know, I told her. I was like, you know, I know what happened to me. And - because I couldn't talk. I had a tube down my throat.

And so I wrote: I know what happened to be but at least now I could be as tall as I want to be. You know? And so she busted out laughing and, you know, we're good to go. And that's when I knew that she was onboard and ready, you know, for us to move forward. It may be a different life, but, you know, I knew that she was ready and it made me stronger.

MARTIN: You were always an athlete and then you're very physically fit. And then you're in the military and you're also very upbeat. Period. Of all of the experiences in your life, which do you think were the most important in helping you recover?

MILLER: Doing a skill correctly. Those are huge in your recovery process. But I think the biggest part for me was being able to be around others who have gone through a similar situation as me. They may have been in a wheelchair. It didn't matter. They could've been paraplegics or whatever, but it was just seeing them move on and have productive lives.

It gave me more hope and strength in the fact that, OK, I'm going to be fine. I think that that's the most part — it's about the camaraderie. It's about getting out. It's about not being ashamed of myself when I go outside. You know, being a woman, a lot of who you are, a lot of how your days goes depends on how you look. You know, if I had a bad hair day, I didn't want to go outside. You know?

So, you know, imagine losing two legs. But seeing someone else go through it and seeing how they deal with the day-to-day and seeing that, oh, she has a date, you know, or he's married, he has a job, those are the things that are important - getting back out in society.

MARTIN: We're talking about adjusting to life after losing one or more limbs. Needless to say, we're thinking about this in the wake of the attack on the Boston Marathon, which was just last week. A number of people we know have lost limbs and we're talking about how to adjust to this with physical therapist Ignacio Gaunaurd and Paralympian Kari Miller, who's a double amputee.

Ignacio Gaunaurd, Dr. Gaunaurd, I have to ask you about the gender difference. Have you noticed a difference in gender about how people respond to this?

GAUNAURD: With the women I have worked with, they all have been these amazing, amazing women that have - at times I feel like are even - that show a little more gumption than the men, especially initially. Just like anything else, I think it's, you know, the fact that they have lost limbs that will impact, you know, the way they look at themselves.

But I think it - as well it affects the men. So it's, from my experience I think it affects them equally.

MARTIN: Kari, is there something you particularly still miss?

MILLER: I loved to wear my little tight jeans and high heel shoes and, you know, to go out in my, you know, stilettos and Manolos, you know, those type of clothes. And, you know, I can wear a heel up to a point right now, you know, but I kind of miss that, just being able to do that, you know, and...

MARTIN: Can't you still wear your cute jeans?

MILLER: Well, you know, the thing is, it depends on which legs I have on, but I guess one of the things when I first got injured, you know, being a woman, the first thing I wanted to do was to be back to normal. I wanted to look like everyone else, so I could care less on how the prosthetics functioned just as long as they - when I put on my jeans, it looked like I had regular legs, you know, and now it's like it's all about function for me. I don't wear the legs that have the covering on it, really. I mean I wear my shorts and whatever because, you know, I kind of think it's cool. You know, it's a way of showing, you know - yes, I have this injury or whatever, but look at me, I'm still moving around.

MARTIN: What are some of the things that you would ask other people to do to be supportive to you, particularly when you were first learning to adjust to your new reality?

MILLER: Don't baby me, because I mean I was never babied to begin with and so it's like, it's a weird situation you're being put in. You're like, well, I'm unable, you know, to move forward? I mean I think the other thing is I have faith in them, you know, to push them in a positive light and don't go into that dark place with them. You know, you push them more to the positive side. Don't let them fall into that little hole.

MARTIN: Dr. Gaunaurd, what about you? Any advice for people who are trying to support people who are going through this?

GAUNAURD: There are support groups out there to help these individuals. The Amputee Coalition - they have over 250 support groups all around the country. They'll be speaking to someone that's been through what they're currently going through and someone who's achieved more than they can imagine. And just understand that the first year is a long process. It's an up and down rollercoaster and they will return back to their prior level of function or even achieve goals that they never thought they could achieve.

MARTIN: Kari, how do you feel about people staring at you or looking at you? And how do you feel about kids asking you questions? For example, I would imagine - do kids ask questions? I would imagine that, you know...

MILLER: Yeah.

MARTIN: ...because kids are a lot less inhibited than adults usually are. How do you feel about that?

MILLER: I love it. I mean, because this - every chance I have to be able to, like, educate someone on, you know, what's going on with me, I mean, I'm able to do it. I think the part that I don't like is when the kids are, you know, staring or asking questions to their parents that they kind of - the parents kind of like shy away or get nervous. I was just at Reagan Airport and I ran into this little kid - touches his mom and he's like, Mom, what happened to her legs? You know, he's says, Mom, ask that lady. And I was like - and the mom was like, no, no. And I was like, no. You can ask. Have him come over here, you know, and we talked and, you know, he ended up taking a picture with my medal, touching my leg and thinking it's cool rather than worrying about it.

You know, so I think just being open and it's not anything to be ashamed of and that's one of the things that I want people to understand, is that having lost your leg is not something to be ashamed of, you know.

MARTIN: Kari Miller is a two time Paralympic silver medalist in volleyball. She's also a double amputee and an Army veteran. Kari, can I thank you for your service as well?

MILLER: Oh, yeah.

MARTIN: I had to slip that in. We caught up with her in Oklahoma City. Also with us, Ignacio Gaunaurd. He is a physical therapist. He has a doctorate in physical therapy. He has a specialization in amputee rehabilitation. He works with wounded veterans primarily. He was kind enough to join us from member station WLRN in Miami.